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Outrageously high C-section rate prompts new rules

Brazil’s incredibly high C-section rates are due for an overhaul, but how likely is it that the new rules will bring that rate down?

At private hospitals in Brazil, the C-section rate is mind-boggling — around 85 percent of births there are surgical. It’s definitely better in the country’s public hospitals (around 45 percent), but it’s still far from ideal.

However, there have been new rules put in place to combat this much-too-high rate. What are the rules, you ask?

  • Moms must be informed of the risks of Cesarean birth
  • Moms must sign a consent form
  • Doctors must be able to justify the surgical birth by keeping detailed records of labor and birth
  • Each woman will have a file on her pregnancy, which she can take with her if she changes doctors

These are all standard practices in the U.S., but by taking these additional steps in Brazil, it’s hoped that the astronomically high rate begins to come down.

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There is a pretty big concern, despite these new rules. It’s not really an easy solution as it sounds on the surface, as BBC reports that private hospitals often book up with moms who want a scheduled delivery, leaving those who want a vaginal birth without a place to labor and deliver. Even worse, it’s said that women in Brazil are often turned off by vaginal birth, and even doctors prefer the operating room because they feel it’s less risk for them professionally.

C-sections are an amazing medical advancement, one that many mothers and children owe their lives to. Back in the “old days,” some women suffered and died when vaginal delivery wasn’t possible. But what should be reserved as an essential procedure when circumstances dictate it is sometimes being sought after as a first-line preference.

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While the C-section rate in the U.S. is lower than Brazil’s, it is still pretty high. In 2013, the most recent year for which records are available, the rate was 32.7 percent. The World Health Organization suggests the ideal rate (which would show a true medical need) should be between 10 and 15 percent, so there is concern that surgical deliveries are being performed at an unnecessary pace.

While modern C-sections are efficient and generally safe, they do still carry some undesirable risks that are not present during most vaginal deliveries, such as excessive blood loss, damage to surrounding organs, blood clots and infection. This publication examines the trend towards more surgical births and what medical care providers should keep in mind as they work with moms-to-be through labor and delivery.

For moms, it can be tempting to schedule a C-section and know a baby’s birth date in advance. It can be awesome for planning your leave from work, for example, or child care for older siblings. But for health reasons, it’s often better to leave those surgical deliveries for true medical emergencies and situations, as your chances of having a subsequent vaginal birth are reduced — in addition to facing greater risk due to the delivery and recovery itself.

It will be interesting to see if these new rules in Brazil have the intended effect, because something definitely needs to be done, and sooner rather than later.

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